A retrospective analysis of factors influencing the success of vaginal delivery after cesarean section

CHANG Lihua; YAN Feiyan; ZHANG Mei

Abstract：Objective To analyze the influencing factors of successful vaginal delivery (VBAC) among re-pregnant women after cesarean section (CD) retrospectively. Methods Data on obstetric treatment of 200 cases of TOLAC between November 2014 and July 2016 in our hospital was retrospectively analyzed. 130 cases of vaginal delivery were assigned to the VBAC group while another 70 cases of vaginal trial production failure served as the control group. Related factors were compared between the two groups. The most contributing factors of VBAC success rate were analyzed by Logistic regression multivariate analysis. Results Single factor analysis of VBAC success rate: Statistically significant difference was detected between the VBAC group and control group in the prenatal BMI, gestational weeks, the time of last cesarean section, prior vaginal deliveries, the cervix dilation at admission, and whether the woman was admitted to hospital before labor (P<0.05). Multivariate analysis: The success rate of VBAC was affected by prenatal BMI, gestational age at delivery, prior vaginal deliveries, and cervix dilation. Prenatal BMI (OR=1.802), gestational age at delivery (OR=2.056), a history of previous vaginal delivery (OR=2.129), the time since the previous cesarean section (OR=0.879), cervix dilation upon admission (OR=1.050), whether the labor hospital (OR=0.832) were factors that could affect the success rate of VBAC. A history o a previous vaginal delivery had the biggest OR. Conclusion The prenatal BMI<28 kg/m2, gestational age≤40 weeks, a history of a previous vaginal delivery, and uterine dilatation ≥5 cm are the influencing factors of the success rate of VBAC, and a history of a previous vaginal delivery is the most important one.